Definition

Gastroesophageal reflux (GER) is the back up of acid or food from the stomach to the esophagus. The esophagus is the tube that connects your mouth and stomach. GER is common in infants. It may cause them to spit up. Most infants outgrow GER within 12 months.

GER that progresses to esophageal injury and other symptoms is called gastroesophageal reflux disease (GERD). The backed-up acid irritates the lining of the esophagus. It causes heartburn, a pain in the stomach and chest.

GERD can occur at any age.

Gastroesophageal Reflux Disease

Causes

GERD is caused by acid or food from the stomach that regularly backs up into the esophagus. It is not always clear why the acid backs up. The reasons may vary from person to person. There may also be a genetic link in some GERD.

Acid is kept in the stomach by a valve at the top of the stomach. The valve opens when food comes in. It should close to keep in the food and acid. If this valve does not close properly, the acid can flow out of the stomach. In addition to GERD, the valve may not close because of:

Dental problems due to the effect of the stomach acid on the tooth's enamel

Feeling full almost immediately after eating

Chronic heartburn

Diagnosis

Your doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Your child may need to see a pediatric gastroenterologist. This type of doctor focuses on diseases of the stomach and intestines.

Tests may include:

Images may need to be taken of your stomach and esophagus. This can be done with an
upper GI series
.

Tests may be done of your bodily tissues. This can be done with an
upper endoscopy
with biopsy.

24-hour pH monitoring—a probe is placed in the esophagus to measure the level of acid

Short trial of medications—the doctor may use the success or failure of a medication to understand the cause

Treatment

Talk with your doctor about the best treatment plan for your child. Treatment options include the following:

Lifestyle Changes

Your child's doctor may suggest making lifestyle changes before trying medication. These changes may include:

Procedures

Surgery or endoscopy may be recommended for
more severe cases. It may be considered if lifestyle changes and medications do not work.

The most common surgery is called
fundoplication. During this procedure, a part of the stomach will be wrapped around the stomach valve. This makes the valve stronger. It should prevent stomach acid from backing up into the esophagus. This surgery is often done through small incisions in the skin.

Prevention

Most causes of GERD in children are unknown. Some cases of GERD may be prevented by:

Following recommended lifestyle and dietary changes if your child had GER

CANADIAN RESOURCES:

References:

Gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD) in children and adolescents. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/ger-and-gerd-in-children-and-adolescents/Pages/facts.aspx. Updated August 2006. Accessed May 10, 2013.

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